Orthodox doctors are taught that 90 per cent of diagnoses are concluded from the history of the condition and the story the patient tells. Eastern philosophies, as I mentioned with regard to experienced Chinese physicians who only take the pulses, often pay little heed to the patient’s complaint and concentrate on the signs and diagnostic techniques through observation and palpation . It will come as no surprise to find that I think a mix and balance of the two is the answer. There is no doubt that listening to a story will lead to an understanding of the condition, especially of its origins, provided that the right questions are asked. It is important not to assume that an illness originated from when the patient first started to feel symptoms. The onset of a headache may be because of drinking the night before. The symptoms of cancer or diabetes may only become apparent at the last stage of the disease.
I feel that it is also important for a patient to express his/her concerns and the way that this is expressed should give the practitioner clues as to how to respond and answer a patient’s concerns. A tearful report should not be answered by a brusque response. A patient who is clearly a matter-of-fact type who gives clear and concise symptoms probably does not want to hear about the ethereal imbalances within his/her Qi. A symptom report is not just about the symptoms but also about assessing the needs of the individual.
From the patient’s point of view, therefore, it is important to present the problem in his/her own way and not as the patient would expect the practitioner to want it. Try not to be a ‘Oh and another thing . . .’ patient. A holistic physician is interested in the ‘whole’ and it is important for all the symptoms to be made available, however irrelevant they may seem to the individual. A good practitioner should elicit all the information needed but sometimes serious symptoms are not owned up to by the patient and may be so removed from the reason for the consultation that a practitioner may not ask. An example is a patient of mine who sat with me for 40 minutes whilst we discussed all the possible underlying causes for her insomnia. As we were parting company I heard the physician’s dreaded comment ‘Oh, another thing doctor, I have been passing blood whenever I have gone to the toilet for the last three weeks’. Needless to say, I worked late that day.
Use of instruments
The stethoscope is a prerequisite for the archetypal physician to wear around the shoulders. In
DIAGNOSTIC TECHNIQUES fact most doctors will tell you that the stethoscope is of limited use in diagnosis except for a cardiologist. Very few treatment protocols change because of the findings from a stethoscope examination. A physician can tell whether a lung is well-congested or a bowel is blocked by listening directly with the ear. The stethoscope makes things easier or confirms diagnosis. Modern machines can allow us to hear and monitor heart beats within a foetus and can certainly be beneficial in obstetrics.
If you do not think that your practitioner is listening to or hearing your complaints or symptoms, then make mention of this and be satisfied with the explanation or change your practitioner.
Make a list of complaints because even the smallest factor may make an enormous difference in the ability to diagnose or prescribe. This is particularly the case in homeopathy.
A copy of your list handed to the practitioner on entering the consulting room may make things easier for you both.